The proposed Collaborative Design in the Clinical Domain Program is designed to provide senior biomedical engineering students with experience in a necessary, but often forgotten, dimension of biomedical engineering design - determining whether or not the device or system they are designing will really be used in the clinical setting and whether it will truly improve patient care. Building from the first five semesters of an integrated design program, this program comprises the final three semesters and one summer of the students' curriculum. All students in the undergraduate BME program will participate, with a maximum cohort size of 40. During the winter semester of the junior year, students will review the design processes and tools that they have previously been introduced to. In addition, they will be educated in techniques to support observational exercises in clinical settings and facilitating discussions with clinical practitioners. During the summer between the junior and senior year, students will participate in a summer-long externship program in which they will spend 4 hours per week working with medical and health care mentors. This may include doctors, nurses, physical or occupational therapists, and others. The externships will be selected based on areas of health care that are most directly applicable to the student's assigned capstone project for their senior year. Externs will be expected to observe their mentors in the clinical environment and assess how biomedical engineering may be able to support or improve patient care. The students will also lead discussions to help the clinicians identify what areas may be supported by the design of biomedical engineering devices or systems. Finally, students will return to campus to participate in a 2-semester capstone design project in which they will design, prototype, and test a device or system to address a problem presented to them by a client. During the capstone experience, students will refer to their new understanding of the clinical environment and will also interact with new clinicians or users of medical devices to insure that their design most appropriately addresses the identified needs. The outcome of this program will be biomedical engineers who have both an understanding of how things actually happen in the clinical environment and a comfort with interacting with health care providers in that setting. Such engineers will be much better prepared to work in the multidisciplinary teams that are needed to develop systems and devices that will improve patient care and reduce societal costs.